One Way Stem Cell Therapy Works: Waking Up Local Cells

How do stem cells work? We know some things. For example, stem cells can both differentiate (turn into) another cell and excrete chemicals to coordinate a repair response. They can transfer good mitochondrial batteries to a dying cell with bad batteries. They can also transfer some of their RNA into another cell and make it produce proteins. Now a new study also suggests that stem cells injected into a joint may be able to wake up local cartilage repair cells.

The Structure of a Joint

To understand the new research, you need to understand the structure of a joint. We’ll use the knee as an example. Joints consist of a variety of structures that all work in unison to provide smooth and proper movement. These include bones (in the knee, this would be the distal end of the femur, or the upper-leg bone, and the proximal end of the tibia, or lower-leg bone), ligaments (e.g., anterior cruciate ligament, or ACL), muscles, nerves, and cushioning and shock absorbing structures (in the knee, this would be the cartilage and meniscus).

Arthritis affects the cartilage and bone, damaging it and wearing it down further and further over time. In mild and moderate arthritis, the cartilage has been worn down or damaged to some degree, but there is still cartilage remaining. Severe arthritis occurs when it has reached the point of bone-on-bone arthritis and no cartilage remains. There are many things that can put us at risk for arthritis, such as hypertension, metabolic syndrome, a low-fat, high-carb diet, a sedentary lifestyle, NSAIDs, steroid injections, and surgeries that remove shock absorbing material. Injuries, such as a vehicle accident, can also lead to arthritis.

In our experience and based on our published studies, stem cell therapy can be a helpful treatment for knee pain stemming from arthritic knees, but how, exactly, does this work? A new study provides one of likely many answers to this question.

New Study Suggests That One Way Stem Cell Therapy Works is by Stimulating Local Cells to Wake Up and Repair Cartilage

The new study set out to answer this question: is it the mesenchymal stem cells themselves regenerating damaged cartilage, or are they stimulating the local cells to wake up and repair the cartilage? Frankly, we have many studies which all suggest a different mechanism of action for stem cells, like all of the ones described above. So this study was never going to be definitive, but more designed to see if in this experimental design, stem cells worked a certain way.

This was a complex study in which mice were bred to recognize donor cells as their own host cells (to replicate a bone marrow stem cell therapy in which a patient’s own stem cells are harvested and reinjected). The researchers found that while the stem cells do attach to the damaged cartilage and that this is indeed imperative to regenerate the cartilage, in this study, it isn’t actually the injected stem cells that regenerate the cartilage—at least not directly. Instead, the action of the injected stem cells, the study found, is necessary to stimulate the local cells (knee, shoulder, etc.) to wake up and repair the cartilage.

Also, make sure you keep the above study in context, as we have lots of studies showing many ways stem cells work and none is definitive, including this study. For example, we have research showing that the stem cells can stay in the joint and turn into cartilage and others that show that the cells only act as an orchestra leader for the symphony of repair.

The upshot? It’s always interesting to see new studies on how stem cells work. I’m sure we’ll see more of these studies coming down the pike in the future!

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First you state that stem cells can not create new cartilage where none exists. But then you say we have research showing that the stem cells can stay in the joint and turn into cartilage. Does this imply that some cartilage has to be there for this to happen?
Thanks,
Don

Chris Centeno, M.D. is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. Centeno regularly lectures on regenerative medicine and has spoken twice at the Vatican Stem Cell Conference, as well as the NFL Combine.

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*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.